Dot-com slowdown got you down? Maybe some time away from the computer would do you some good.

While the tech revolution has clearly been a boon for many, we tend to ignore the potential human costs. Rather than coasting along in a risk-free career, computer workers face a very real threat from debilitating Repetitive Strain Injury (RSI), according to mounting evidence.

Hard statistics on the frequency of injury in technical fields remain difficult to find. But according to the U.S. Department of Labor's Bureau of Labor Statistics, already 66.3 percent of occupational illnesses reported are RSI cases.

RSIs are a serious problem. Too often the severity of the injuries go unrecognized, or are silently tolerated by workers who don't want to jeopardize their careers. Many don't believe the risk of injury is real. But left untreated for too long, some RSIs can become so severe that they incapacitate sufferers, not for the duration of an economic slowdown, but for good.

Ryan, a 29-year-old freelance Web designer, wasn't thinking about the possibility of permanent injury when he first noticed symptoms of RSI in May of 1999. At that time, he was spending 8 to 10 hours a day on the computer. When he wasn't working on freelance assignments for pay, he was working on his own projects after hours.

The first symptom Ryan noticed was swelling in his elbows and wrists. He had no doubt the inflammation was a result of too much time spent on the computer, yet he continued working just the same. After all, he had deadlines to meet.

By the time he delivered his final designs to his client a month later, Ryan was in the throes of his first full-blown flareup.

Ryan's symptoms had progressed to include numbness, tingling and pain in both arms. Each arm showed visible redness, and swelling that covered the area from 3 inches above the bicep down to the wrist. It had gotten so bad, he says, "people were calling me Lobster Boy."

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Ryan's condition is particularly severe. But RSI cases like his are not as uncommon among high-tech professionals as was once believed.

Laura, also 29, is an art director at one of the prominent Web consultancy companies in San Francisco. In October of 1999, she began to notice troubling symptoms relating to time spent in front of the computer, including pain and numbness in both arms and hands.

Two months later, as the pain became more and more difficult to tolerate, Laura sought professional diagnosis. Not long thereafter, she filed a Workers' Compensation claim for RSI.

Receiving treatment for her condition, however, proved difficult. Few doctors were experienced in the kind of injury Laura was suffering. Initial treatment involving medication and physical therapy proved ineffective.

Paul, a mid-level manager for a major financial services company in San Francisco, shares Laura's frustration in finding effective RSI care. "No one's up on this at all," he says.

He first noticed his own symptoms while working in computer data entry. He experienced numbness, shooting pains and swelling in both hands and wrists. But because his symptoms were intermittent, he went almost a year before seeking treatment. By then, the injury had spread to include his forearms, back, shoulders, elbows, neck and chest.

The physician Paul eventually saw was a general practitioner, since his company health plan does not include an RSI specialist. This doctor, he feels, was only interested in finding a quick fix solution.

Carpal tunnel syndrome is a form of RSI that received wide attention from the mainstream media in the 1990s. Because of this attention, both sufferers and physicians alike tend to characterize all work-related arm and hand pain as carpal tunnel syndrome. But in truth, every RSI case is unique. Some injuries affect the tendons, while others strike the nerves, muscles and even bones. Each type carries a different diagnosis, and different treatment needs.

Paul was handed a diagnosis of carpal tunnel syndrome by his doctor, but Paul doesn't feel the label accurately describes his symptoms. And even combined with the usual regimen of anti-inflammatory drugs, it hasn't helped him recover.

Laura, too, was frustrated by early misevaluation of her condition and inadequate care. "Nobody knows how to diagnose me," she explains, "because the problem is not in my tendons. I have a problem with my muscles."

Laura eventually found some relief through chiropractic treatment and deep tissue massage. Since beginning these therapies, Laura's condition has shown some improvement. But she emphasizes that she is in no way "fixed."

Ryan has had marginally better luck receiving treatment for his condition. He first sought professional care in June of 1999, when he was prescribed physical therapy and non-steroidal anti-inflammatory drugs. Neither of these seemed to have any effect on his condition. Eventually, he would be referred to the Berkeley practice of Dr. Wladislaw Ellis.

Ellis was recommended to Ryan as having 15 years' experience treating occupational-related RSI. But if Ryan thought Ellis' expertise would give him increased hope for a fast recovery, he was wrong. Instead, says Ryan, "he basically gave me a death sentence."

According to Ryan, Ellis insisted in no uncertain terms that he had never seen a 100 percent recovery. The only real possibility for improvement, he said, was a change in behavior. The patient has to cease the activities that caused the injury, completely and indefinitely.

Though this prognosis is hardly encouraging, Paul agrees. He cites a period of two months when he was on vacation, and observed no symptoms. The only effective cure for his condition he has found is, he says, "basically to stop working."

Laura, too, had a similar experience. "At no time in the future will I be able to spend 10 to 12 hour days on the computer again," she insists. "I can spend three to four hours a day on the keyboard at most."

But to simply "stop working" is easier said than done. Laura has been fortunate, in that the Web design firm she works for has been willing to accommodate her special needs. They've provided her with ergonomic furniture to reduce the risk of compounding her injury, and have allowed her to reduce the number of hours she spends on the computer.

But Paul, who works for a large corporation, is reluctant to seek his company's assistance. He fears the inevitable bureaucracy he would encounter should he report a work-related injury. If he were to report his injury, the best he could hope for would be that he'd be able to file a workers' compensation claim.

Laura can attest firsthand to how ineffective such a claim can be. She was recently ordered to appear at the offices of a doctor, not her own physician, selected by the workers' compensation program.

The appointment lasted no more than seven minutes. Once complete, the doctor composed a 10-page report outlining an array of physical and neurological tests he had supposedly performed. He managed this, Laura recalls, without ever touching her arms.

The result of the report is that Laura is now classified under the program as "Permanent and Stationary" -- meaning that while her condition is not improving, it's not getting any worse either. That means her injury can be quantified into a monetary amount, and the level of benefits she's entitled to receive can be capped.

With this development, Laura is concerned that she might not be able to continue the treatments that have helped her condition improve. Since neither chiropractic nor massage is commonly covered by health plans, obtaining them at all proved difficult.

As for Ryan, he's been even less fortunate when it comes to continuing care. "I totally fell between the cracks," he explains. "I was a freelancer. I wasn't employed, so I couldn't get workers' compensation. And I didn't have disability insurance because nobody my age thinks they need it."

Ryan will have to keep working, but his options seem very limited. "There's not a lot of leeway in our working society for this kind of stuff," he says.

These experiences are all too typical of government's and the health care system's ignorance and neglect of the severity of the RSI problem. In March, President Bush reversed legislation originally passed during the Clinton administration that would have required employers to take measures to prevent RSIs. But even had the law held, most RSI sufferers are skeptical of government's ability to prevent these types of workplace injuries.

Still, something must be done. A 1993 study by the California Workers' Compensation Institute suggested that the cost of RSI claims averages $21,453. And in 1997, the AFL-CIO estimated that the total cost of RSIs to industry might be as high as $20 billion annually.

But these figures aside, for Ryan the RSI problem remains a very personal one. For a while, he considered getting a management position, to avoid having to work directly on the computer himself. But he soon learned that much of a manager's day is spent composing e-mails and typing reports, strict no-nos for someone with Ryan's injury.

Not yet 30, he's now faced with some tough realities. "Basically, this condition has been a catalyst for a kind of early mid-life crisis," he explains. "What am I really here for? What do I want to do with my life? What am I going to do for a living?"

Ultimately, Ryan feels the greatest improvements he has seen since first noticing his symptoms have come from changes in his own attitudes. Maybe this current economic slowdown offers the tech sector the same opportunity. Perhaps it's time to take a breather and do some serious thinking about our own work habits, our futures and ourselves.

Neil McAllister is a writer, Internet developer, and technology consultant based in San Francisco. Last year, he spent $1000 on ergonomic furniture. nmcallister@sfgate.com